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Mysql:

INSERT INTO `his_examine_result` (Mid,His_Examine_Mid, His_File_Mid, ResultType, His_Employee_Mid,
                                  His_Employee_Name, ExamineResult, ExamineItemName, ExamineStandardName, 
                                  ExamineItemUnit, ExamineHighValue, ExamineLowValue, ExamineDiscription, Discription)
    VALUES ($mid,$examineMid,$fileMid,1,null,null,'',$itemName,$standName,$itemUnit,$highValue,$lowValue,'','') 
ON DUPLICATE KEY UPDATE ExamineResult=$result,ExamineDiscription=$dis

SqlServer:

if NOT exists(SELECT * FROM Setting WHERE ID=0)INSERT INTO Setting(ID,Title,SearchKeys, ServiceIntervalSecond,SleepMillisecondPerSearch) VALUES(0,@title,@searchKeys,@serviceIntervalSecond,@sleepMillisecondPerSearch) ELSE UPDATE Setting SET Title=@title,SearchKeys=@searchKeys,ServiceIntervalSecond=@serviceIntervalSecond, SleepMillisecondPerSearch=@sleepMillisecondPerSearch